Comprehensive Reform to Improve Health System Performance in Mexico

The Lancet; 368(9546): 1524-1534

Posted: 25 Apr 2012 Last revised: 28 Sep 2012

See all articles by Julio Frenk

Julio Frenk

Bill and Melinda Gates Foundation

Eduardo Gonzalez-Pier

Independent

Octavio Gómez-Dantés

Government of Mexico - Center for Health Systems Research

Felicia Knaul

Mexican Health Foundation; Harvard Global Equity Initiative

Date Written: October 25, 2006

Abstract

Despite having achieved an average life expectancy of 75 years, much the same as that of more developed countries, Mexico entered the 21st century with a health system marred by its failure to offer financial protection in health to more than half of its citizens; this was both a result and a cause of the social inequalities that have marked the development process in Mexico. Several structural limitations have hampered performance and limited the progress of the health system. Conscious that the lack of financial protection was the major bottleneck, Mexico has embarked on a structural reform to improve health system performance by establishing the System of Social Protection in Health (SSPH), which has introduced new financial rules and incentives. The main innovation of the reform has been the Seguro Popular (Popular Health Insurance), the insurance-based component of the SSPH, aimed at funding health care for all those families, most of them poor, who had been previously excluded from social health insurance. The reform has allowed for a substantial increase in public investment in health while realigning incentives towards better technical and interpersonal quality. This paper describes the main features and initial results of the Mexican reform effort, and derives lessons for other countries considering health-system transformations under similarly challenging circumstances.

Keywords: System of Social Protection in Health, Seguro Popular

JEL Classification: I18

Suggested Citation

Frenk, Julio and Gonzalez-Pier, Eduardo and Gómez-Dantés, Octavio and Knaul, Felicia, Comprehensive Reform to Improve Health System Performance in Mexico (October 25, 2006). The Lancet; 368(9546): 1524-1534. Available at SSRN: https://ssrn.com/abstract=2046354

Julio Frenk

Bill and Melinda Gates Foundation ( email )

P.O. Box 23350
Seattle, WA 98102
United States

Eduardo Gonzalez-Pier

Independent ( email )

No Address Available

Octavio Gómez-Dantés

Government of Mexico - Center for Health Systems Research ( email )

Mexico

Felicia Knaul (Contact Author)

Mexican Health Foundation ( email )

Periférico sur 4809, El Arenal Tepepan, Tlalpan
El Arenal Tepepan, Tlalpan
Mexico, D.F., 14610
Mexico
(52) 55 56559011 (Phone)
(52) 55 56559082 (Fax)

HOME PAGE: http://http//www.funsalud.org.mx

Harvard Global Equity Initiative ( email )

FXB Building, Room 632
651 Huntington Avenue
Boston, MA 02115
United States
(617) 4327938 (Phone)

HOME PAGE: http://isites.harvard.edu/icb/icb.do?keyword=k62597&pageid=icb.page268594

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